Opinion: Doctors, insurers can improve management of health care costs

Jerome Frankel and Daniel J. Loepp

The most crucial health care relationship for any person is the one they have with their primary care physician. The doctor-patient relationship is critical to maintain patient wellness, and to deliver the early interventions that are proven to be most effective in combating acute and chronic disease.

Early interventions delivered by primary care doctors not only help people be healthier, they also enable costs to be better managed. Plainly put, if a malignant tumor is identified at stage one, it can be treated with far more success and far less cost than if it goes unchecked.

The doctor-patient relationship is critical to maintain patient wellness, Frankel and Loepp write.

For more than a decade, Oakland Southfield Physicians has worked in partnership with Blue Cross Blue Shield of Michigan and other provider organizations to strengthen primary care in our state. We’ve given patients greater access to high-quality, coordinated care that meets their personal needs. And we’ve rewarded providers for successfully meeting quality metrics.

But we need to go further. Our patients and insurance members continue to be cost conscious with their health care expenses. We need to do more to strengthen our shared accountability for quality and cost.  We are pleased to be engaged on this objective through an innovative program called Blueprint for Affordability.

Oakland Southfield Physicians is one of the first physician groups to sign an agreement with Blue Cross for the Blueprint for Affordability program. It’s a new payment model, where select physician organizations and hospitals have agreed to tie their reimbursement for services to their patient outcomes to make health care better and more affordable for the people we serve. It’s a model all physician organizations in Michigan should consider.

Under Blueprint, when physicians successfully manage patients’ health according to care standards, and when they keep the total cost of care down, they are rewarded with a share of the savings generated for the year.

But if they don’t meet care standards, and if total cost of care is too high, providers could owe money to Blue Cross’s customers.

The goal is more proactive, preventive health care that reduces the need for hospital admissions and costly treatments — which saves patients and the system money.

Blueprint prioritizes coordination among the health care community, and that is good for patients. We’ve already seen how patients with asthma or diabetes stay healthier when we work together to manage their care, track their results and offer extra options to see them in the doctor’s office.

And, we know that when patients get the right care at the right time, they avoid unnecessary hospitalizations and ER visits, and other expensive services that drive up their costs for health care.

It’s our shared responsibility to provide coordinated, patient-centered care. We are putting accountability into practice as health care professionals by partnering on the Blueprint for Affordability program.

We believe this is the best path forward. We’re willing to put dollars on the line to ensure better, more affordable health care. We encourage more health care providers to join us in this effort.

Jerome Frankel is medical director of Oakland Southfield Physicians. Daniel J. Loepp, is president & CEO of Blue Cross Blue Shield of Michigan.